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Multi-modality Imaging of Ischemia With 18F-FDG PET and CTA

This study has been terminated.
(Continued recruitment of study participants was not feasible)
Information provided by (Responsible Party):
Terrence Ruddy, Ottawa Heart Institute Research Corporation Identifier:
First received: July 15, 2011
Last updated: April 21, 2017
Last verified: April 2017
Coronary artery disease results in narrowing of the blood vessels supplying oxygenated blood to the heart muscle. Diagnosis in patients with symptoms of chest pain is now quickly done with CT coronary angiography. This x-ray test can show narrowed blood vessels but has limited ability to predict the severity of the narrowings in some cases. We have described a new approach using PET exercise 18F-FDG imaging as a method to image areas of heart muscle not getting enough blood during exercise stress. The 18F-FDG images are co-registered with the CT anatomy from the CTA to provide direct evidence of the consequences of the narrowing.

Condition Intervention Phase
Myocardial Ischemia Radiation: PET MPI imaging with 18F-Fluorodeoxyglucose Phase 4

Study Type: Interventional
Study Design: Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Diagnostic
Official Title: Direct Imaging of Ischemia With 18F-FDG PET Imaging Combined With Coronary Anatomy From CT Coronary Angiography

Resource links provided by NLM:

Further study details as provided by Terrence Ruddy, Ottawa Heart Institute Research Corporation:

Primary Outcome Measures:
  • Extent of ischemia as determined by visual and quantitative analysis [ Time Frame: at time of scan ]

Secondary Outcome Measures:
  • The degree of correlation between the multiple modalities (CTAm stress PET or SPECT and 18FDG PET) [ Time Frame: 3 to 9 months ]

Enrollment: 18
Study Start Date: December 2011
Study Completion Date: January 2015
Primary Completion Date: January 2015 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: 18F-FDG PET imaging
Positron Emission Tomography nuclear stress scan following either pharmacologic or treadmill stress test with radiopharmaceutical injection at peak stress or within 1 hour following peak stress.
Radiation: PET MPI imaging with 18F-Fluorodeoxyglucose

Exercise Stress Testing. All patients will undergo a symptom-limited exercise treadmill test using the Bruce protocol after a 24 hour high fat, low carbohydrate diet and an overnight fast. Persantine Stress Testing: Subjects who have undergone Persantine stress protocol for the PET or SPECT will follow the same protocol. A high fat, low carbohydrate diet for 24 hours and a 12 hour overnight fast will precede the study stress scan. Anti-anginal medications will be withheld on the morning of the exercise test.

18FDG (370 mBq) will be injected at either peak exercise or within 1 hour of peak.

Patients will be imaged 60 minutes after radiotracer injection in the supine position in a Discovery 690/VCTLYSO PET system (GE Healthcare, Milwaukee, Wisconsin)

Detailed Description:

The Investigators and others have demonstrated direct imaging of myocardial ischemia using 18F-Fluorodeoxyglucose (18FDG) with exercise or dipyridamole stress and positron emission tomography (PET) or single photon emission computed tomography (SPECT). This approach with "hot-spot" imaging may have greater diagnostic accuracy for ischemia than conventional "cold-spot" myocardial perfusion imaging.

Recent advances in multi-modality imaging permit fusion of CTA images with PET or SPECT perfusion images and functional assessment of anatomical CAD. Registration of the 2 data sets can be optimized using the CT acquired with the PET or SPECT15. 18FDG uptake as a marker for ischemia can be directly related to the coronary anatomy and guide revascularization.


Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:

  1. Patients with suspected CAD referred for CTA and found to have moderate CAD stenoses and 20 normal volunteers with less than 5% probability of CAD.
  2. Age ≥ 18 years

Exclusion Criteria:

  1. Inability to undergo stress protocol due to co-morbidities
  2. Pregnancy
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Please refer to this study by its identifier: NCT01520025

Canada, Ontario
University of Ottawa Heart Institute
Ottawa, Ontario, Canada, K1Y 4W7
Sponsors and Collaborators
Ottawa Heart Institute Research Corporation
Principal Investigator: Terrence D Ruddy, MD Ottawa Heart Institute Research Corporation
  More Information

Responsible Party: Terrence Ruddy, Principal Investigator, Ottawa Heart Institute Research Corporation Identifier: NCT01520025     History of Changes
Other Study ID Numbers: HI Protocol #2011397-01H
Study First Received: July 15, 2011
Last Updated: April 21, 2017

Keywords provided by Terrence Ruddy, Ottawa Heart Institute Research Corporation:
Multi-modality imaging
Metabolic Imaging of Ischemia
Myocardial blood flow
Myocardial blood flow reserve

Additional relevant MeSH terms:
Myocardial Ischemia
Coronary Artery Disease
Pathologic Processes
Heart Diseases
Cardiovascular Diseases
Vascular Diseases
Coronary Disease
Arterial Occlusive Diseases
Fluorodeoxyglucose F18
Molecular Mechanisms of Pharmacological Action processed this record on September 19, 2017